The second seminar of the series featured a panel of five speakers, and was designed to be more interactive with the audience members. The topic was much less introductory, going deep into practice by discussion “shocks” to the system and responses to these. As was expected, one of the biggest shocks facing a health system is the onset of a global pandemic, which served as the bulk of the discussion.
Representing the South African, Peruvian, UK and Saudi Arabian health systems, this seminar served to showcase the strengths and limitations of different health systems and their capacity to deal with the Covid-19 pandemic.
With five presentations and high audience engagement, discussion was highly stimulating. There was agreement that a shock to a health system is a situation that stretches resources and, more than testing limits, showcases existing limits that a health system has.
Kicking off with a high-level view on the role of workforce planning during a state of shock, Professor James Buchan from UTS Australia mentioned his work in roughly 50 to 60 countries, and how many situations are the same in all. Some of the issues he mentioned included supply and distribution of health workers, what entails workforce planning, and creating a workforce fit for Universal Health Coverage purposes. There was overall agreement that coordination at the policy level, along with distinctions in the needs of workforce planning represent the main focus for shock readiness.
“[It is] really important to differentiate ‘workforce demand shortages’ i.e. insufficient funding to ensure workforce posts [that are] consistent with UHC, from ‘workforce supply shortages’ where demand exists but supply has not been adequately planned for.” – Rob Smith, Director of Workforce Planning and Intelligence for HEE.
There are overlaps around the world. These include using existing resources, having the ability to coordinate towards a common purpose, having the right policies aimed at creating responses at scale, which is more important when systems are fragmented, as is the case in Peru and South Africa.
“Our interventions have to be sustainable and absorbable by the country, as stated by Prof Buchan. The starting point is ensuring that interventions are developed and co-driven by the national department. Another thing to mention in our case: [the British High Commission] work with an extensive network of South African health experts and institutions as downstream partners, so delivery is done at a meaningful level.” – Tori Bungane, Attaché for the British High Commission in South Africa.
All presentations were informative in design, but Doctor Yaseen Arabi introduced a different, more positive perspective on shock readiness, given that the Kingdom of Saudi Arabia has faced coronavirus outbreaks in the past, namely the Middle East Respiratory Syndrome, MERS, outbreak in 2012. With a 51% death rate, this outbreak, and following surges, resulted in drastic changes to the Saudi health system, which proved instrumental in tackling the Covid-19 pandemic starting in 2020.
Having listened to Saudi Arabia’s readiness given their experience with a less widespread but more deadly coronavirus, and witnessing the large amount of data that this Covid-19 pandemic has produced regarding the health workforce and its limits in different health systems, it is clear that shocks to the system are a transformation opportunity. In some cases, health systems were forced to implement digital healthcare delivery methods by force, which in the long run can represent a positive shift towards adoption of new technology. In other cases, it highlighted the need for systemic workforce planning, with a clear breakdown of locations and specialties that need investment. All of these are highly valuable intelligence, which Nichole McIntosh directed towards leaders: there needs to be a focus on “learning from Covid, instead of blaming.”